Hypertension:

– The initial dose: 50 mg once daily or 25 mg x 2 times daily. If satisfactory reduction of blood pressure has not been achieved after 1 or 2 weeks the dose may be increased to 100 mg daily in 1 or 2 divided doses. If the blood pressure has not been satisfactorily controlled after 1-2 weeks at this dose (and the patient is not already received a diuretic), a modest dose of a thiazide-type diuretic (e.g, hydrochlorothiazide 25 mg daily), should be added. If further blood pressure reduction is required, the dose may be increased incrementally while continuing the diuretic and a 3 times daily dosage schedule may be considered.

– The dose in hypertension usually does not exceed 150 mg/day. A maximum daily dose of 450 mg should not be exceeded.

Heart failure:

– In patients with either normal or low blood pressure, who have been vigorously treated with diuretics and who may be hyponatremic and/or hypovolemic, a starting dose of 6.25 mg or 12.5 mg x 3 times daily may minimize the magnitude or duration of the hypotensive effect. For these patients, titration to the usual daily dosage within the next several days.

– For most patients, the usual initial daily dosage is 25 mg x 3 times daily. After a dose of 50 mg x 3 times daily is reached, further increases in dosage should be delayed, where possible, for at least 2 weeks to determine if a satisfactory response occurs. Most patients had a satisfactory improvement at 50 mg or 100 mg x 3 times daily. A maximum daily dose of 450 mg should not be exceeded.

Left ventricular dysfunction after myocardial infarction:

– Greater efficacy is achieved if therapy initiated after three days following myocardial infarction. The initial dose is 6.25 mg, therapy should be increased to 37.5 mg daily. Captopril should then be increased as tolerated to 75 mg daily during the next several days to a final target dose of 150 mg daily over the next several weeks.

Diabetic nephropathy:

– Daily dose: 75 mg-100 mg in equally divided doses.

– Dosage adjustment in renal impairment: Captopril in divided doses of 75 mg daily was tolerated. For patients with severe renal impairment, initial daily dosage should be reduced and smaller increments utilized for titration over 1 to 2 weeks intervals. After the desired therapeutic effect has been achieved, the dose should be slowly back-titrated to determine the minimal effective dose.